Trump Supporters Have the Most to Lose in the G.O.P. Repeal Bill

The people who stand to lose the most in tax credits under the House Republican health plan tended to support Donald J. Trump over Hillary Clinton in the 2016 election, according to a new Upshot analysis.

Over all, voters who would be eligible for a tax credit that would be at least $1,000 smaller than the subsidy they’re eligible for under Obamacare supported Mr. Trump over Hillary Clinton by a seven-point margin.

The voters hit the hardest — eligible for at least $5,000 less in tax credits under the Republican plan — supported Mr. Trump by a margin of 59 percent to 36 percent.

These estimates are based on data from the Kaiser Family Foundation and the Cooperative Congressional Election Study (C.C.E.S.), a large survey of tens of thousands of Americans. Kaiser estimated whether individuals would gain or lose under the Republican plan to replace the Affordable Care Act, based on their income, age and insurance market.

We matched the data to the C.C.E.S.’s postelection survey, which asked individuals about their health care and how they voted in the 2016 presidential election. The end result: an estimate for how much every respondent of the survey would gain or lose under the Republican plan, based on age, income and county.

Like any result based on a survey, the estimates are imperfect. But the Republican plan offers less assistance to older and lower-income Americans, especially in rural areas, according to the Kaiser data. These groups generally backed Mr. Trump. Most of all, President Trump’s white working-class supporters often make enough money to be ineligible for Medicaid, but not enough to afford costly health insurance that might even become more expensive under the Republican plan.

The plan would hit older and rural Americans hardest because it wouldn’t provide a larger tax credit to people with more expensive plans. Older Americans pay the highest premiums, and the law would allow insurers to raise premiums for older customers even further. The AARP opposes the bill as a result.

Rural areas often have higher premiums because there’s less competition. Residents in those areas would receive the same subsidy as people in cheaper markets.

This analysis is limited to people who don’t receive Medicare or Medicaid. But Medicaid recipients, who also stand to lose under the law, lean more Democratic. Nationwide, Medicaid recipients supported Mrs. Clinton by a margin of 55 percent to 39 percent, according to the C.C.E.S. data.

The effects of the Republican plan on Medicaid recipients are less clear. Many of them might lose their Medicaid coverage or see their benefits pared back as a result of the bill.

The law would reduce funding for a major expansion of the Medicaid program for poor Americans in more than 30 states and cut future Medicaid funding across the country. Most of those 30 states supported Mrs. Clinton, but Mr. Trump led by 49-46 percent among Medicaid beneficiaries in the nine red expansion states that have voted Republican in the last two presidential elections.

Republican senators from those states are among those most skeptical of the repeal bill, and many of the same states have large rural populations that stand to lose the most under the plan’s tax credits.

It’s important to note that while many of Mr. Trump’s supporters might be eligible for a smaller tax credit under the Republican plan, only a fraction of those voters would be immediately affected. According to the C.C.E.S., about 4 percent of Mr. Trump’s supporters purchased a plan on exchanges last year.

The estimates include all people with the potential to be eligible for the subsidy and don’t receive Medicare or Medicaid, not just those who purchased health care on the individual market and already receive a subsidy under the Affordable Care Act.

The data on the slice of voters who currently have insurance purchased on an exchange is thinner. Over all, people who bought their health insurance on exchanges supported Mrs. Clinton by a margin of 55 percent to 39 percent, according to the C.C.E.S. But among the small sample of respondents who would lose more than $5,000 under the Republican plan, more were Trump supporters than Clinton supporters.